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Neuro Pharmacology > Psychopharm > Flashcards

Psychopharm Flashcards

1
Q

When is Psychological treatment first line

A

Anxiety, OCD , mild-moderate depression

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2
Q

Examples of Typical Antipsychotics

A
  • Chlorpromazine
  • Haloperidol
  • Sulpride
  • Zuclopenthixol (clopixol)
  • Fluphenazine
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3
Q

Examples of Atypical Antipsychotics

A 
• Lurasidone
• Olanzapine
• Quetiapine
• Risperidone
• Aripiprazole
• Amisulpride
-Clozapine
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4
Q

What is psychosis

A

Disorder of excess dopamine

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5
Q

What type of drugs are Antipsychotics

A

Dopamine Antagonists at D2 receptors

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6
Q

Do Antipsychotics affect negative symptoms

A

No

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7
Q

What are the Dopamine Pathways Relevant to Schizophrenia Syndromes

A

Positive - overactivity of mesolimbic pathway

Negative & cognitive - Dysfunction of mesocortical pathway

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8
Q

Adverse Affects of Antipsychotics

A

Mediated by dopamine antagonism
1- Nigrostriatal tract - Extra pyramidal side effects (EPSE) : Acute dystonia , Akathisia, tardive Dyskinesia, Parkinosonism
2- Tuberoinfundibular system –prolactin elevation

Mediated by other receptors 
• Serotonin
• Histamine
• Muscarinic
• Alpha adrenergic
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9
Q

Which side effects are more common with 2nd generation Antipsychotics , which drugs specifically

A

Metabolic Effects
• Weight gain
• Dyslipidaemia
• Type 2 diabetes

Specifically: Quetiapine, olanzapine and clozapine

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10
Q

Antidepressants Types

A

SSRIs : Selective serotonin reuptake inhibitors
SNRIs : serotonin and noradrenaline reuptake inhibitors
NASSAs : noradrenergic and specific serotinergic
MAQIs : monoamine oxidase inhibitors
TCAs: tricyclic antidepressants

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11
Q

SSRIs MOA

A

Block serotonin transport in synapse , blocking the reuptake of serotonin into neurons = increase serotonin activity

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12
Q

What causes Depression

A

Functional deficiency of monoamines ( serotonin and noradrenaline ) : research not verified

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13
Q

How do antidepressants work

A
  • Increase BDNF and stimulate neurogenesis = enhancing synaptic plasticity
  • moderates limbic system to reduce cognitive bias
  • increase serotinergic neurotransmission to modulate other neurotransmitter systems ( GABA , dopamine )

MOST effective with psychological and social interventions

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14
Q

What are Anxiolytics

A

Anxiety medications ; Benzodiazepines and GABA receptors

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15
Q

What is GABA-A receptor

A

important target for benzodiazepine and Z drugs

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16
Q

How do Benzodiazepines work

A

Increase affinity for GABA

  • binding site is between alpha and gamma subunits
  • different subunits will have different affects
17
Q

Uses of benzodiazepine

A
  • Anxiolytic
  • Hypnotic
  • Muscle relaxant
  • Anti-convulsant
  • Amnestic
18
Q

Benzodiazepine affect on subunits a1 to a6

A
  • α2 and 3: anxiolytic
  • α1 and 5: sedation, amnesia and ataxia
  • α1-6: anticonvulsant
19
Q

Side Effects of Benzodiazepines

A
  • Headaches
  • Confusion, amnesia
  • Ataxia
  • Dysarthria
  • Blurred vision
  • Paradoxical (disinhibition) reaction
  • At risk: children, LD, CNS disorder, impulsivity
  • Interaction with alcohol at GABA receptor
  • Overdose –rarely fatal alone but dangerous in combination with alcohol
20
Q

Where does alcohol interact

A

GABA receptor

21
Q

List drugs that act on GABA other than benzodiazepines

A
  • Z drugs
  • Barbituates
  • Flumazenil
  • Alcohol
22
Q

What are Z drugs

A

Ex: Zolpidem, zopiclone

  • Bind to benzodiazepine site at GABA-A receptor
  • Short onset of action
  • Specific to α-1 subtype –Hypnotic
  • Anticonvulsant and muscle relaxant only at high doses
  • Same Side effects as benzodiazepines
23
Q

What are barbiturates

A

Ex: Amobarbital, phenobarbital, thiopentone
- used only for severe insomnia, epilepsy, induction of
anaesthesia
- Highly addictive, dangerous in overdose

24
Q

What is Flumazenil

A

Competitive antagonist in benzodiazepine binding site

  • Displaces Benzodiazepine
  • Rapid onset of action but short half life
  • shouldn’t be used if benzodiazepine is being used to treat epilepsy
25
Q

What can be used to treat benzodiazepines OD

A

Flumazenil

26
Q

Where is Alcohol an antagonist

A

At Glutamate receptors

27
Q

Why do barbituates have a higher risk of toxicity

A

Benzodiazepines : increase affinity of GABA = increase frequency of opening of chloride channels , can only act if GABA present

Barbituates : increase duration chloride channels opening and can act in absence of GABA if at high doses = higher risk of OD

Neuro Pharmacology (2 decks)

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